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General NPI Number Information
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NPI Number | 1083506679
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Entity Type | Individual
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Provider Name | JULIA M FRYZEL DMD
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Gender | Female
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Dates
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Enumeration Date | 07/17/2025
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 4125 MEXICO RD
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City | SAINT PETERS
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State | MO
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Zip | 63376-6410
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Country | US
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Telephone | 636-447-4080
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Fax |
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Provider Business Mailing Address
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Address Line | 435 BLUFF ST APT 1/2
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City | ALTON
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State | IL
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Zip | 62002-6012
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Country | US
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Telephone | 708-205-5133
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2025028486
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License Number State | MO
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